Splinting the Hand to Enhance Motor Control and Brain Plasticity

Abstract

Theoretical constructs on the values of splinting the hand are reviewed. Therapists treating poststroke patients face a fast changing technology environment. This new technology allows scientists and physicians the opportunity to evaluate brain function. Scientists can increase understanding of the effects of stroke on function based upon location and severity. Physicians can evaluate the effects of medication and their interaction with the brain. Technology is unmasking the brain's vast ability to adapt and restore function due to its plasticity. Therapists must be diligent to gain knowledge of this everchanging science. Current research challenges the efficacy of splinting patients who are post stroke. If muscle and joint systems are allowed to become stiff and nonfunctional, what becomes of the sensory input to the brain? Now more than ever, therapists have an opportunity to apply motor reeducation with functionally based tasks and demonstrate the value of rehabilitation. This will only be realized if the peripheral muscle and joint systems are kept at a functional length. Custom splints applied after careful evaluation and as a adjunct prior to treatment will maximize functional outcomes.

Revolutionizing Stroke Rehabilitation: Dynamic Glove-Based Rehabilitation System Empowered by CNN for Spastic Hands.

“…Neglecting to treat upper limb spasticity results in contractures due to abnormal shortening of the soft tissue structures surrounding the joints such as joint capsules, ligaments; tendons; muscles, and the skin [14]. mobilization and spasticity resulting in musculoskeletal tightness which decreases the functional recovery of the hand [15]. When left in the immobilized state with the flexor synergy; the condition of the upper limbs progresses to a fibrotic state which triggers the development of early contractures [15].…”

“…mobilization and spasticity resulting in musculoskeletal tightness which decreases the functional recovery of the hand [15]. When left in the immobilized state with the flexor synergy; the condition of the upper limbs progresses to a fibrotic state which triggers the development of early contractures [15]. Pain: fibrosis, contracture, movement disorders, and muscle weakness usually accompanied by spasticity.…”

“…One of the rehabilitation treatments in stroke patients is using dynamic splints to reduce spasticity of the Hand and maintain muscle tissue length [16], It increases joint range of motion by providing a low-load prolonged timed tissue stretch. Dynamic splints can improve hand function by maintaining the peripheral muscle and joint structures at a functional length [15]. Hand mobility should be facilitated by using dynamic splints which stretch the muscles; tendons and ligaments to maintain their length, so reducing spasticity [14].…”

“…Spasticity and impaired hand motor skills can be treated by harnessing the plasticity property of the brain through mass movement and task-oriented arm training [14]. Hand splints can be used to train motor learning and improve neural plasticity in the brain [15]. Using a soft robotic glove as an assistive device was studied before [17][18][19][20][21].…”

Effectiveness of a New 3D-Printed Dynamic Hand–Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients

“…Splints can provide a safe low-load force to the spastic muscles, which facilitates muscle relaxation, maintains muscle length, and prevents contractures [ 19 ], thereby having widespread uses in many clinic settings. However, some previous studies did not support the effectiveness of hand splinting [ 20 , 21 ].…”